Tricky Questions - Spill Management in Healthcare Facilities

WHAT IS SPILL? 

An unintentional or accidental fall, flow or runout of something can be termed as Spill. In Hospitals, these spills include chemicals, hazardous material, drug, blood and other bodily fluids. 

WHAT ARE THE COMMON KINDS OF SPILLS IN THE HEALTHCARE FACILITIES? 

There are four common or major kinds of spills such as: 

Biological Spills – Blood and other bodily fluids, culture of micro-organisms and other infectious materials. 

Chemical Spills – formalin, xylene and other acid, bases and drugs 

Mercury Spills – B.P Apparatus & thermometer mostly but mercury compounds are also used in preservatives and reagents. 

Cytotoxic Spills – cytotoxic drugs and medicines 

HOW SPILLS INTERACT WITH HUMAN BODY?
Harmful materials such as bacteria, viruses and other small organisms, fumes and vapors and inappropriate drug or medicine can enter in to the body by four ways such as: 

• 1.     Inhalation (breathing)
• 2.      Ingestion (swallowing)
• 3.      Absorption (through skin)
• 4.      Injection

WHAT ARE THE RISKS ASSOCIATED WITH THESE SPILLS?

• ·       They may have serious health consequences for instance; microorganism (bacteria, viruses) may gradually impact internal organs badly.
• ·       Mercury beads and its fumes can disrupt nervous system.
• ·       Chemicals and their vapors may cause skin & eye irritation depending upon their properties and nature.
• ·   Cytotoxic drugs (Cancerous drugs) are highly toxic to cells that may lead to adverse effects during exposure. 

WHAT IS THE ROLE OF SAFETY COORDINATOR IN THE EVENT OF A SPILL?

Assess nature of spill and adopt safety measures accordingly:

• ·         Stop the source of spill
• ·         Place caution sign or cordon off the area
• ·         Wear appropriate PPEs from spill kit
• ·         Use appropriate spill items to tackle spill such as absorbent pad etc.
• ·         Dispose of contaminated material including PPE in waste bags (Yellow & Red) or sharp container
• ·         Wash Area or disinfect area through housekeeping staff
• ·         Wash hands
• ·         Re-stock spill kit item

WHAT TO DO IF SAFETY COORDINATOR IS NOT AROUND DURING SPILL?

In this particular scenario, one must stop the source of spill, cordon off the area to avoid exposure and announce code yellow.

WHAT IS MEANT BY MINOR OR MAJOR SPILLS?

Spills that can be triggered through spill kits and without spill kits are termed as minor spill whereas spills that are unmanageable or cannot be tackled through spill kits are major spills. Hence, code yellow is announced for major spills or whenever concerned safety coordinator is not around.

WHAT TO DO IN TERMS OF EXPOSURE?

Try to reach nearby emergency facility such as eyewash bottle, eyewash station and emergency shower depending upon the severity of exposure. If problem still persists, visit EAR or employee health clinic as per need.

WHAT IS THE QUANTITY OF DISINFECTANT (SODIUM HYPOCHLORITE) SHOULD BE USED TO DISINFECT THE AREA?

In the guidelines, its mentioned 2gm/liter for sodium hypochlorite for all others except biological spill that is 100gm/liter.  Remember, the main purpose is to protect yourself and people in the surrounding from the exposure. It’s the minimum quantity and fluctuation in it is acceptable because it’s not a dose to be given to the patient. 

WHAT IS CODE YELLOW?

CODE YELLOW refers to major spills that can be radioactive, gas leakage, hazardous material or chemical spills. However, when safety coordinator is not around then code yellow may be announced.

WHEN CODE YELLOW SHOULD BE ANNOUCED?

In case of spill, one should stop the source of spill, cordon off the area and then inform departmental safety coordinator. He will take rest of the measures.

WHO RESPONDS WHEN CODE YELLOW IS ANNOUNCED?

Team to respond in case of CODE YELLOW:

• ·         Firefighting team because chemical may have flammable characteristics
• ·         Engineering & Maintenance Department (EMD) team to stop the flow, to cut off ignition source and to shut off valve.
• ·         Housekeeping for final cleaning

WHAT IS MEANT BY MSDS?

A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the hazardous materials. Hence, it’s mandatory to keep MSDS file near hazardous materials.

WHAT IS THE USE OF EYEWASH BOTTLE?

Eyewash bottle provides immediate flushing, consists of distilled water and used to clean, refresh & soothe eyes when exposed to chemicals and hazardous materials. 

                            

Remember Safety is more important than Convenience